When legs won’t rest

Thursday

Feb 8, 2007 at 12:01 AM

By Sarah Bruyn Jones Staff Writer

The heebie-jeebies, creepy-crawlies, the jitters and antsy legs are light-hearted names for a medical condition that causes chronic misery to far more people than epilepsy, Parkinson’s disease or other well-known neurological disorders.More than bothersome, but not generally debilitating, restless legs syndrome affects perhaps one in 10 people, but often goes undiagnosed.Dr. James Geyer and his staff at the DCH Sleep Center in Northport Medical Center have compiled a list of more than 100 colloquial names for restless legs. While the symptoms were first documented nearly three centuries ago, the study of restless legs syndrome is fairly recent.It wasn’t until 1995 that the International Restless Legs Syndrome Study Group identified four basic criteria for diagnosing restless legs syndrome. Those criteria are: a desire to move the limbs, symptoms that are worse or present only during rest and are partially or temporarily relieved by activity, motor restlessness and symptoms that worsen at night.It’s not a mere habit or bouncing of the legs. And while it was once thought to be a behavioral condition, Geyer said it is not something that you can learn to control.“I would have a tingling in my feet and legs," said Bernice Hollyhand, 64, of Tuscaloosa.“It was just very uncomfortable. I couldn’t be still. I just felt like I had to move."About 18 months ago, Hollyhand enrolled in a study and the treatments have made a significant difference, she said.“It’s much better," she said. “I didn’t realize how much it did affect me until I got some relief."The relative newness of the condition has made it one of the hottest topics in sleep medicine. Additionally, many researchers and sleep specialists believe it is significantly under-diagnosed. Hollyhand, for instance, said she had it for years but never realized it was a treatable medical condition.So as word spreads, more and more people are realizing they too may have restless legs.“At least 7 percent of the population has it. And it’s probably more than that because a lot of people either don’t admit to having it or don’t know that’s what they have," said Geyer, director of the DCH Sleep Center.Recent research suggests restless legs affects about 10 percent of adults in North America and Europe with rates increasing with age, according to the National Sleep Foundation.For years, Dr. Daniel Potts talked about his “nervous legs." His father had the same “nervous legs."Sometimes it meant he couldn’t sit through a movie without getting up and walking around. Other times, it prevented him from falling asleep.“It’s miserable," he said. “I’ve had it most of my life"It wasn’t until Potts was in his residency for neurology that he realized his chronic restlessness might have a medical explanation. He has since been diagnosed with restless legs syndrome and now takes medication to help ease the irresistible urge to move.“Medication has just changed my life," he said. “Before I just had this irresistible urge to move my legs. I can’t stand it."The availability of FDA-approved medication in 2005 has also contributed to the increased awareness of restless legs. Since then, a second medication has also been approved and studies are underway for additional drug therapies.Still, while medications have been able to ease or eliminate the symptoms, the medical field is unsure what causes restless legs. There are, however, some key aspects that researchers have uncovered. Primarily, it affects many people within the same family, and it gets worse when people are fatigued or in the evening hours.“Usually, if I take care of one person in a family, I’m going to see at least one other person and many times seven or eight come in," Geyer said, adding that it often shows up in people in their 20s and 30s.The most he’s ever treated in one family? Eleven.While the syndrome is often a genetic disorder, it also can be caused by nerve damage and iron deficiencies. If a lack of iron is to blame, it is curable. Otherwise, there is no known cure.When nerve damage is to blame, it is called secondary restless legs, and is usually treated by treating the pain first.Reach Sarah Bruyn Jones at sarah.jones@tuscaloosanews.com or 205-722-0209.